Grand Canyon UniversityDNP-830A- Data AnalysisOctober 6- 202210 Strate.docx

Grand Canyon University
DNP-830A: Data Analysis
October 6, 2022
10 Strategic Points Document for a Quality Improvement Project
Ten Strategic Points
The 10 Strategic
Points
Title of Project
1) Title of Project
Using continuous glucose monitoring to monitor blood glucose in adult
patients with type II diabetes
Background
Theoretical
Foundation
Literature
Synthesis
Practice Change
Recommendation
2) Background to Chosen Evidence-Based Intervention:
i. Background of the practice problem/gap at the project site
Several chronic conditions negatively impact the lives of patients. Among
such conditions is diabetes. Diabetes causes numerous other complications,
such as kidney disease, heart disease, and stroke (Skinner et al., 2020). The
other concern about diabetes is that it affects millions of people, making
them unable to live normal lives. The implication is that various researchers
and stakeholders have, in the past and present, been pursuing effective ways
or strategies to better manage diabetes. Non-the less, diabetes is still among
the most prevalent chronic conditions (Khan et al., 2019). According to
Khan et al. (2019) the diabetes global prevalence among the adult
population is as high as 9%. The interventions currently in use among
patients living with diabetes majorly focus on helping patients attain better
healthcare outcomes, such as better glycemic control and keeping in check
the risky lifestyle behaviors that may hinder the control and management of
the condition (Maiorino et al., 2020). Even though effective interventions
should be applied, the management strategies used in the practice site have
not achieved the desired results as most of the patients fail to achieve the
required HbA1c levels. Indeed, uncontrolled levels of HbA1c have been
connected to myocardial infarction and stroke disease (Azhar et al., 2022).
It hurts to use an invasive glucometer. The discomfort is the same even if
the needle is very small. Some individuals may be able to adjust to it and
tolerate it, but for others, it may be too much to handle, leading to the issue
of non-compliance. The patient's ability to regulate their blood sugar may
suffer as a result, leading to bouts of hyperglycemia and hypoglycemia The

risk of diabetic complications is increased by noncompliance, making it a
potentially life-threatening issue, hence the need to have a different way to
measure glucose more effectively and non-invasively.
ii. Significance of the practice problem/gap at the project site
As earlier highlighted, diabetes causes other undesirable problems apart
from making those who live with it spend more money on treatment and
management (Bommer et al., 2018). Therefore, the need to control and
manage the disease has attracted the attention of several stakeholders,
including nurses, doctors, and other researchers in the medical and nursing
fields. There have been advancements in the management of diabetes,
largely due to the new innovative technologies used in diagnostics and
treatment (Haque et al., 2021). However, the annual number of people who
get the disease still runs into millions. In addition, the prevalence rates have
been rising in recent years, while several others die annually due to diabetes
(Khan et al., 2019). The negative impacts caused by the disease can reduce
through using nursing interventions based on the current technology and
technological applications such as continuous glucose monitoring. The
intervention can dictate the rate of practitioners ordering Continuous
glucose monitoring as directed by the results to further improve outcomes.
The implication is that, in the event that continuous glucose monitoring
leads to improvement in the expected HbA1c levels, then the practitioners at
the project site are more likely to increase the rates of the ordering of
continuous glucose monitoring for better outcomes (Root et al., 2022).
Modern intensive diabetic care relies on regular and precise monitoring of
blood glucose levels. This used to require many time-consuming and
uncomfortable daily random blood glucose readings, which served as a
substantial deterrent to reaching intended blood glucose targets. Self-
monitoring blood glucose (SMBG) simply gives you a single reading of the
blood sugar level and doesn't tell user anything about the trend or pace of
the sugar levels even if used consistently. This means that most individuals,
notwithstanding the checking their glucose concentration multiple times a
day, nonetheless fail to meet their goals. CGM is a major improvement
because it offers immediate evaluation on the efficacy of diabetic therapies
(such insulin delivery), and it gives alerts when serum sugar levels reach
critically excessive or inadequate. more importantly, it offers real-time
glucose reading at regular intervals. This is significant to the research, since
benefits of CGM out do the shortcomings, which include high cost.
iii. Theoretical Foundations (choose one nursing theory and one evidence-
based change model to be the foundation for the project):
Nursing theories are key in implementing nursing interventions as they offer
a framework upon which to base the aspects of interventions (BrandÃ£o et
al., 2019). Therefore, this project will use Dorothea Orem's self-care theory.

The theory is mainly defined as the act of helping others by offering and
maintaining self-care to maintain and improve human functioning at the
home level effectiveness. The theory states that an individual has an ability
to perform self-care as "the practice of activities that individuals initiate and
perform on their behalf to maintain life, health, and well-being (Butts &
Rich, 2018). Dorotheaâ€™s theory has three interconnected sub-theories;
the theory of self-care, the self-care deficit theory, and the theory of nursing
systems (Orem & Calnan, 1972). Dorothea Orem's theory is one of the
nursing theories widely applied in nursing quality improvement and change
initiatives. This theory will be used in guiding the DNP project on diabetes
management and prevention. Self-care is key in diabetes management.
Therefore, the underpinnings will be key in helping the individuals evaluate
themselves and choose the necessary actions required to attend to the needs
of self-care by accomplishing the actions (Butts & Rich, 2018), which in
this case is continuous glucose monitoring. Therefore, patients can be
motivated to follow the interventions for better care. The theory underlines
that self-care is learned and is more natural to adults. Therefore, it will
guide the project toward promoting self-care for healthcare, well-being, and
self-maintenance among the identified patients living with diabetes.
The theory is also appropriate for the management of diabetes as it also
focuses on the possible deficits that the caregivers or the patients may be
having in terms of appropriate resources and information key to better
management (Orem & Calnan, 1972). In addition, the theory also highlights
the inability of patients to take care of themselves, hence the need for
support. The patients will, therefore, be able to lower the chances of
emergency room visits by taking instructions on the use of continuous
glucose monitoring. The use of continuous glucose monitoring also focuses
on self-care as the patients will be required to use the monitors, and the
existence of a deficit will be a springboard to help the caregivers to
collaborate and offer the best to achieve the set goals. Another aspect of the
theory is the application of innovative and creative ideas (Orem & Calnan,
1972). Such ideas are key if the evidence is to be used to positively impact
patient outcomes. As such, upon the improvement of patient outcomes
through glucose monitoring, the impact and the next set of goals will be
communicated to the care teams to help facilitate the new practice with the
major focus of improving patient outcomes.
Lewin's change theory will provide the theoretical foundation and
constructs in the change practice by addressing behaviors, fears, anxieties,
and attitudes and reducing stakeholder worries. Kurt Lewin's change theory
comprises three stages, unfreezing, change, and refreezing (Lewin, 1947);
(Hussain et al., 2018). The theory asserts that there are two types of forces,
the driving and restraining forces pushing in the direction that makes change
happen and the direction that hinders the change, respectively (Lewin,
1947). A change only occurs when the driving forces override the

restraining forces (Cummings et al., 2016). In the unfreezing stage, a
method is proposed to help individuals move from old behavior patterns and
accept change. The change or moving stage entails changing behavior,
feeling, and thoughts. The final step, refreezing, entails making the new
change as a new habit or standard (Lewin, 1947). When applying the
change model, the unfreezing stage will involve asserting the need for
patients to have improved HbA1c levels hence the need for more effective
intervention. During this stage, the nurses involved will ensure that the
patients see the urgency of the need to have well-controlled HbA1c levels.
The second step will involve implementing the proposed intervention to
reduce HbA1c levels in diabetic patients. Support is offered to nurses who
offer the intervention to patients, and the patients are encouraged to adhere
to the intervention requirements. At this stage, the intervention is rolled out,
and the patients are encouraged to use continuous glucose monitoring. The
final step will involve making the intervention part of standard practice to
ensure that patients have better outcomes. Therefore, nurses will be advised
to apply the intervention to patients with diabetes for better diabetes
outcomes. Besides, ordering continuous glucose monitoring by the
practitioners will be expected to be the standard part of the diabetes
management practices at the facility.
iv. Annotated bibliography.
Beck, R. W., Riddlesworth, T. D., Ruedy, K., Ahmann, A., Haller, S.,
Kruger, D., ... & DIAMOND Study Group. (2017). Continuous glucose
monitoring versus usual care in patients with type 2 diabetes receiving
multiple daily insulin injections: a randomized trial. Annals of Internal
Medicine , 167 (6), 365â€“374. DOI: 10.7326/M16-2855.
In this study by Beck et al. (2017), the primary aim was to determine the
effectiveness of continuous glucose monitoring in adults with type 2
diabetes who were getting insulin injections. By employing a randomized
controlled trial as the research design, these researchers recruited one
hundred and fifty-eight patients with type 2 diabetes. Seventy-nine patients
were randomized into the usual care group, with the remaining half
recruited into the intervention group. While the continuous glucose
monitoring group used a Dexcom G4 platinum continuous monitoring
system to monitor their glucose concentrations, the control groups engaged
in glucose self-monitoring. The mean HbA1c levels went down to 7.7 %
and 8.0% in the continuous glucose monitoring group and control group,
respectively (adjusted difference in mean change, âˆ’0.3% [95% CI, âˆ’0.5%
to 0.0%];Â pÂ = 0.022), showing that the intervention was efficacious.
When continuous glucose monitoring was performed, there was a
statistically significant decrease in HbA1c levels among the patients in the
intervention groups. As a result, it suggests that continuous glucose
monitoring is essential for enhancing diabetic outcomes like lowered

HbA1c levels.
Gilbert, T. R., Noar, A., Blalock, O., & Polonsky, W. H. (2021). Change in
hemoglobin A1c and quality of life with real-time continuous glucose
monitoring use by people with insulin-treated diabetes in the landmark
study. Diabetes Technology & Therapeutics , 23 (S1), S-35.
https://doi.org/10.1089/dia.2020.0666
The study by Gilbert et al. (2021) aimed to assess the changes in HbA1c
levels upon using a continuous glucose monitoring system. The recruited
patients were two hundred and forty-eight, with sixty having Type 2
Diabetes.The participants were requested to upload their point-of-care
HbA1c measurements to an online portal. They then used continuous
glucose monitoring devices to monitor their HbA1c values and uploaded
them to the portal. Upon data analysis, the researchers noted that there was a
significant reduction in the levels of HbA1c levels (p-value <0.001). The
HbA1c fell significantly from 8.2% (1.9%) at baseline to 7.1% (1.1%) at the
end of the study ( p <â€‰0.001); besides, 54 % of those with initial HbA1c
values >7% experienced absolute HbA1c reductions of >1%. This study
implied that the improved HbA1c levels among the patients are the results
of continuous glucose monitoring. Therefore, this study also indicated the
importance of continuous glucose monitoring in improving HbA1c and the
management of diabetes.
Heinemann, L., Freckmann, G., Ehrmann, D., Faber-Heinemann, G.,
Guerra, S., Waldenmaier, D., & Hermanns, N. (2018). Real-time continuous
glucose monitoring in adults with type 1 diabetes and impaired
hypoglycemia awareness or severe hypoglycemia treated with multiple
daily insulin injections (Hypo DE): a multicentre, randomized controlled
trial. The Lancet , 391 (10128), 1367-1377. https://doi.org/10.1016/S0140-
6736(18)30297-6
This study was done by Heinemann et al. (2018). This study's objective was
to determine whether real-time continuous glucose monitoring can
effectively reduce the severity and incidences of hypoglycemia. In a six-
month randomized controlled study, the researchers randomly assigned 75
individuals to a real-time continuous glucose monitoring group, while 74
were assigned to the control groups. The individuals in the real-time
continuous glucose monitoring group were taught how to use the
monitoring system. They then used real-time continuous monitoring devices
for the period of study. On the other hand, the individuals in the control
group used glucometer to self-monitor their blood glucose levels at regular
intervals during the day. Upon the analysis of the data, it was noted that the
individuals in the intervention group reported a significant reduction in
hypoglycemic events (p-value of <0.0001). The mean number of
hypoglycemic events per month in the continuous glucose monitoring group

was reduced from 10Â·8 (SD 10Â·0) to 3Â·5 (4Â·7); changes in the control
group were not significant (from 14Â·4 [12Â·4] to 13Â·7 [11Â·6]).
Incidence of hypoglycemic events decreased by 72% for participants in the
continuous glucose monitoring group (incidence rate ratio 0Â·28 [95% CI
0Â·20â€“0Â·39], p<0Â·0001). The study implied that the use of continuous
glucose monitoring led to a significant reduction in HbA1c levels hence
showing the importance of the intervention in diabetes management and
care.
Martens, T., Beck, R. W., Bailey, R., Ruedy, K. J., Calhoun, P., Peters, A.
L., ... & MOBILE Study Group. (2021). Effect of continuous glucose
monitoring on glycemic control in patients with type 2 diabetes treated with
basal insulin: a randomized clinical trial. JAMA , 325 (22), 2262-2272.
doi:10.1001/jama.2021.7444
This article presents the findings of the research done by Martens et al.
(2021). This study was done with the aim of finding the impacts of
continuous glucose monitoring in improving individuals' HbA1c levels
when compared to the impact of blood glucose meter monitoring. In a
randomized controlled trial, these researchers recruited a total of 175 people
with diabetes. While the individuals in the intervention group used
continuous glucose monitoring, the ones in the control group engaged in
blood glucose meter monitoring. This study was done for a period of eight
months. Upon analyzing the data, it was noted that the individuals in the
intervention group showed a substantial reduction in HbA1c levels (p-value
of 0.02). There was also a significant difference between the intervention
and control groups (p-value of 0.001). Mean HbA1c level decreased from
9.1% at baseline to 8.0% at eight months in the continuous glucose
monitoring group and from 9.0% to 8.4% in the control group (adjusted
difference, âˆ’0.4% [95% CI, âˆ’0.8% to âˆ’0.1%]; p= 0.02). The results
imply that continuous glucose monitoring leads to a more significant
reduction in HbA1c levels, indicating that the intervention is effective.
Grace, T., & Salyer, J. (2022). Use of Real-Time Continuous Glucose
Monitoring Improves Glycemic Control and Other Clinical Outcomes in
Type 2 Diabetes Patients Treated with Less Intensive Therapy. Diabetes
Technology & Therapeutics , 24 (1), 26-31. DOI: 10.1089/dia.2021.0212.
Authored by Grace & Salyer (2022), this study focused on using real-time
continuous glucose monitoring in the management of patients with diabetes
type to improve glycemic control. The researchers recruited patients
suffering from diabetes with basal insulin only or noninsulin therapy. At six
months, the researcher found relevant outcomes. For example, the
participants showed a considerable reduction in HbA1c levels
(âˆ’3.0%â€‰Â±â€‰1.3%, p-value <0.001). In addition, the researchers
observed a reduction in the average levels of glucose at six months

(âˆ’23.6â€‰Â±â€‰38.8, P <â€‰0.001). Therefore, continuous glucose
monitoring was connected with significant glycemic improvements among
patients suffering from the diabetes disease.
v. Practice Change Recommendation: Validation of the Chosen Evidence-
Based Intervention
The standards of diabetes care have been used at the facility for years as a
preference. However, this approach has not been as effective as expected.
As such, this research proposes to investigate whether the increased
prescription of continuous glucose monitoring as an intervention to help
patients with diabetes have improved HbA1c levels, as shown in the
research done by Beck et al. (2017). In a randomized controlled trial, the
researchers randomized (n=79) patients in a continuous glucose monitoring
group while (n=79) were in the control group. The continuous glucose
monitoring group used a Dexcom G4 platinum continuous monitoring
system to monitor their glucose concentrations to give a better reduction in
HbA1c levels as compared to the control group (p values of 0.022). The
analysis of the study findings showed that the mean HbA1c levels went
down to 7.7 % and 8.0% in the continuous glucose monitoring group and
control group, respectively (adjusted difference in mean change, âˆ’0.3%
[95% CI, âˆ’0.5% to 0.0%];Â PÂ = 0.022), showing that the intervention
was efficacious (Beck et al., 2017). As such, this randomized controlled trial
study shows that continuous glucose monitoring can effectively improve
HbA1c levels among these patients with the diabetes illness hence a
recommendation for practice change (Beck et al., 2017).
vi. Summary of the findings written in this section.
Diabetes is one of the most common and disabling chronic conditions.
However, the application of nursing interventions can be key to improving
patient outcomes (Beck et al., 2017). From the annotations, it is evident that
the use of continuous glucose monitoring as an intervention in managing
diabetes leads to a better control in patientâ€™s blood glucose, even though
the cost of purchasing it is significantly higher. For example, the researchers
reported significant improvement in the HbA1c levels upon the use of
continuous glucose monitoring. When the results for the control groups
were compared with intervention groups, significant improvements among
the intervention groups were observed. For example, the reduction in the
HbA1 levels observed between the intervention and control group by Beck
et al. (2017) was significant (p= 0.022); Gilbert et al. (2021) observed ( p
<â€‰0.001), Heinemann et al. (2019) observed ( p <â€‰0.001); Martens et
al. (2021) also observed ( p <â€‰0.001); Grace & Salyer observed (p
<0.001)
Problem
Statement
3) Problem Statement:

It is not known if the implementation of the translation of research by Beck
et al. (2017) on continuous glucose monitoring to improve the rate of
practitioners' ordering continuous glucose monitoring would impact HbA1c
levels among patients with diabetes.
PICOT to
Evidence-Based
Question
4) PICOT Question Converts to Evidence-Based Question:
Among adult patients with diabetes in an outpatient clinic, will the
translation of Beck et al.'s research on continuous glucose monitoring
increase the rate of practitioners ordering continuous glucose monitoring
impact HgbA1C compared to current practice in 12 weeks?
Evidence-Based Question:
Provide the templated statement.
To what degree will the implementation of continuous glucose monitoring
impact HbA1c levels among adult patients with diabetes in an urban
outpatient clinic.
Sample
Setting
Location
Inclusion and
Exclusion Criteria
5) Sample, Setting, Location
i) Sample and Sample Size: The sample will be based on a convenient
sample of 16 adult patients diagnosed with diabetes. The sample will then
be divided into two, the control group and the intervention group, each
having 8 patients. One of the potential biases is selection bias, as the
patients recruited will be ones known to the facility and attending the
facility for the management of diabetes. Another potential bias is that the
samples will be from one center, hence a lack of generalizability.
The sample size of 16 patients is obtained by taking 10% of the total
diabetic adults who visit the hospital, which is 160 patients
ii) Setting: The setting for the study is an urban Outpatient care primary
clinic.
iii) Location: an outpatient primary care Clinic area
iv) Inclusion Criteria
Patients must be at least 18 years and above and have diabetes. The patients
should also be able to speak and understand English. The patient should also
not form part of another study. The participants must be willing to
participate in the study and must be competent in that they should be able
make sound decisions on their own.
v) Exclusion Criteria

Patients under the age of 18 years will be excluded. Only those who suffer
from diabetes illness will be included. Individuals using technological
management of diabetes, those who do not want to sign the consent forms,
and those who have a mental disability will be excluded.
Define Variables
6) Define Variables:
i) Independent Variable (Intervention): continuous glucose monitoring
Continuous glucose monitoring: Continuous glucose monitoring is a
technological process of automatically tracking a personâ€™s glucose
concentrations throughout out the night and day.
ii) Dependent Variable (Measurable patient outcome): HbA1c levels
Glucose concentrations: In reference to this project, blood glucose levels
refer to the amount of the glucose in the patientâ€™s system as measured
by the continuous glucose monitors.
HbA1c levels: In reference to this project, HbA1c levels refer to average
glucose concentrations measured at baseline and at the end of the
intervention to determine the efficacy of the intervention
Project Design
7) Project Design:
This project will use a quality improvement approach.
i. Quality Improvement: A quality improvement is an initiative or project
focused on improving patient care efforts and outcomes. These initiatives
focus on initiating changes to lower the chances of making medical errors,
improving care, and ensuring safety. Quality improvement efforts also help
formulate processes and standard work to bridge gaps for better patient
outcomes. Quality improvement is vital in improving an organizationâ€™s
performance and reducing costs. According to Fischer & Wick, 2020,
quality improvement is key in delivering quality patient care composed of
six aspects: patient-centered, equitable, timely, efficient, effective, and safe.
Therefore, the use of the quality improvement approach in this study will
seek to explore current research and translate the found evidence into
practice for the major purpose of improving patient outcomes, which in this
case is better HbA1c levels among patients with diabetes. As opposed to
research, quality improvement uses the existing evidence and translates the
same into practice.
ii) Research: Research entails replicating or testing new ideas to improve
the standard practice and current knowledge. A systematic strategy is
applied to investigate a clinical question or problem, leading to the
formulation of a hypothesis which then triggers efforts to prove such
hypothesis and generate new knowledge (Glasofer & Townsend, 2021).

Research is significant in nursing in that it produces scholarly evidence,
which is then used as a guide to the professional nursing practice. Research
differs from quality improvement in that it applies a systematic strategy to
investigate a new idea and come up with new knowledge and theories.
Therefore, research informs quality improvement.
iii) Summarize: Research and quality improvement both complement each
other in terms of improving patient care outcomes. In addition, even though
the two are connected, they are different. While research mainly formulates
new knowledge, theories, and hypotheses, quality improvement focuses on
translating the research findings into practice
Purpose Statement
8) Purpose Statement:
Provide the templated statement.
The purpose of this quality improvement project is to determine if the
increased prescription of continuous glucose monitoring would impact
HbA1c levels among adult patients with diabetes disease. This project will
be piloted over a twelve-week period in an urban Outpatient primary care
clinic.
Data Collection
Approach
9) Data Collection Approach:
i) The demographic information or data for the patients, such as gender, co-
morbidities, ethnicity, race, and age, will be collected. The demographic
data for the patients will be collected through documentation during
recruitment as provided by the patients. The patient's knowledge of
continuous glucose monitoring will also be evaluated using a questionnaire
(Revised Brief Diabetes Knowledge Test instrument). The reliability of the
Revised Brief Diabetes Knowledge Test instrument is (Î± â‰¥ 0.70), while
the validity ranges from 0.83 to 0.96
ii) The patient's HbA1c levels will be measured, and the baseline data will
be obtained from the electronic health records. Data from EHR has been
shown to be reliable and valid. The obtained data at the end of the study
period will then be entered into a password-protected database.
iii) The step-by-step process for collecting the data,
Step 1: Obtaining IRB approval for data collection
Step 2: Baseline patient HbA1c data will be obtained from the facilityâ€™s
EHR.
Step 3: The patient's HbA1c will be measured after the intervention, and the
two values will be compared. The results will also be compared between the

intervention and the control group.
iv) Various potential ethical issues include the protection and storage of
patient health information. This information will be stored in password-
protected computers where only individuals with unique passwords will
access the information. The patient data will also be de-identified to further
improve security and confidentiality. In addition, the obtained data will be
kept for one year after graduation before destroying them, following the
Grand Canyon's guidelines.
v) The project will adhere to the principle of Belmont by ensuring that no
harm is done to the patients. Patients will also be encouraged to participate
in the study without coercion freely. Besides, none will be unfairly excluded
from participating in the study. Patient data will also be protected to remain
confidential and unauthorized access blocked. The patients will be shown
the necessary respect in terms of autonomy and be treated without bias, just,
fairly, and equally.
Data Analysis
Approach
10) Data Analysis Approach:
i. The participant's data will be analyzed using the IBM SPSS statistics
software. The central tendency measures will be used in summarizing the
characteristics of the patients. They will be the mean or average of
continuous and discrete data and the median.
ii. Descriptive statistics will be applied in analyzing the collected
demographic data such as gender, co-morbidities, ethnicity, race, and age.
iii. Descriptive analysis will also be used to describe the population as well
as what happens with the computation of standard deviations, median, and
mean. It will also help in describing the variables and their relationships
through the use of a mixed linear regression model.
iv. Data will be obtained from EHR and the continuous glucose monitoring
database platform.
v. There will be a review of the HbA1c levels obtained using continuous
glucose monitors.
vi. Paired sample t-test and Pearson's correlation will be used to determine
the significant differences between the intervention data and baseline data
and between the groups.
vii. A statistician will also be consulted to help with the statistical aspects of
the project.
Potential data bias can result in the possible improved glycemic control

could be as a result of the intervention and other self-care activities that the
patient undertakes outside the study. One way of mitigating data is through
the use of an appropriate study design. The Hawthorne effect is also
possible since the patients will be in the know that they are part of the study
and, therefore, their behavior is being kept under watch
References
Azhar, S., Khan, F. Z., Khan, S. T., & Iftikhar, B. (2022). Raised Glycated
Hemoglobin (HbA1c) Level as a Risk Factor for Myocardial Infarction in
Diabetic Patients: A Hospital-Based, Cross-Sectional Study in Peshawar.
Cureus , 14 (6). Doi:10.7759/cureus.25723
Beck, R. W., Riddlesworth, T. D., Ruedy, K., Ahmann, A., Haller, S.,
Kruger, D., ... & DIAMOND Study Group. (2017). Continuous glucose
monitoring versus usual care in patients with type 2 diabetes, this is
receiving multiple daily insulin injections: a randomized trial. Annals of
Internal Medicine , 167 (6), 365â€“374. https://doi.org/10.7326/M16-2855.
Bommer, C., Sagalova, V., Heesemann, E., Manne-Goehler, J., Atun, R.,
BÃ¤rnighausen, T., ... & Vollmer, S. (2018). Global economic burden of
diabetes in adults: projections from 2015 to 2030. Diabetes care , 41 (5),
963-970. https://doi.org/10.2337/dc17-1962
BrandÃ£o, M. A. G., Barros, A. L. B. L. D., CaniÃ§ali, C., Bispo, G. S., &
Lopes, R. O. P. (2019). Nursing theories in the conceptual expansion of
good practices in nursing. Revista Brasileira de Enfermagem , 72 , 577-581.
https://doi.org/10.1590/0034-7167-2018-0395
Butts, J. B., & Rich, K. L. (2018). Philosophies and theories for advanced
nursing practice . Jones & Bartlett Publishers.
Cummings, S., Bridgman, T., & Brown, K. G. (2016). Unfreezing change as
three steps: Rethinking Kurt Lewinâ€™s legacy for change management.
Human relations , 69 (1), 33â€“60.
https://doi.org/10.1177/0018726715577707
Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns
Hopkins evidence-based practice for nurses and healthcare professionals:
model & guidelines . Sigma Theta Tau International
Fischer, C., & Wick, E. (2020, November). An AHRQ national quality
improvement project for implementation of enhanced recovery after
surgery. In Seminars in Colon and Rectal Surgery (Vol. 31, No. 4, p.
100778). WB Saunders. https://doi.org/10.1016/j.scrs.2020.100778
Gilbert, T. R., Noar, A., Blalock, O., & Polonsky, W. H. (2021). Change in
hemoglobin A1c and quality of life with real-time continuous glucose
monitoring use by people with insulin-treated diabetes in the landmark

study. Diabetes Technology & Therapeutics , 23 (S1), S-35.
https://doi.org/10.1089/dia.2020.0666
Glasofer, A., & Townsend, A. B. (2021). Determining the level of evidence.
Nursing , 51 (2), 62â€“65.
https://doi.org/10.1097/01.nurse.0000731852.39123.e1
Grace, T., & Salyer, J. (2022). Use of Real-Time Continuous Glucose
Monitoring Improves Glycemic Control and Other Clinical Outcomes in
Type 2 Diabetes Patients Treated with Less Intensive Therapy. Diabetes
Technology & Therapeutics , 24 (1), 26-31.
https://doi.org/10.1089/dia.2021.0212 .
Haque, W. Z., Demidowich, A. P., Sidhaye, A., Golden, S. H., &
Zilbermint, M. (2021). The Financial Impact of an Inpatient Diabetes
Management Service. Current Diabetes Reports , 21 (2), 1-9.
https://doi.org/10.1007/s11892-020-01374-0 .
Heinemann, L., Freckmann, G., Ehrmann, D., Faber-Heinemann, G.,
Guerra, S., Waldenmaier, D., & Hermanns, N. (2018). Real-time continuous
glucose monitoring in adults with type 1 diabetes and impaired
hypoglycemia awareness or severe hypoglycemia treated with multiple
daily insulin injections (Hypo DE): a multicentre, randomized controlled
trial. The Lancet , 391 (10128), 1367-1377. https://doi.org/10.1016/S0140-
6736(18)30297-6
Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M.
(2018). Kurt Lewin's change model: A critical review of the role of
leadership and employee involvement in organizational change. Journal of
Innovation & Knowledge , 3 (3), 123-127.
https://doi.org/10.1016/j.jik.2016.07.002
Khan, R. M. M., Chua, Z. J. Y., Tan, J. C., Yang, Y., Liao, Z., & Zhao, Y.
(2019). From pre-diabetes to diabetes: diagnosis, treatments, and
translational research. Medicina , 55 (9), 546.
https://doi.org/10.3390/medicina55090546
Maiorino, M. I., Signoriello, S., Maio, A., Chiodini, P., Bellastella, G.,
Scappaticcio, L., ... & Esposito, K. (2020). Effects of continuous glucose
monitoring on metrics of glycemic control in diabetes: a systematic review
with meta-analysis of randomized controlled trials. Diabetes Care , 43 (5),
1146-1156. https://doi.org/10.2337/dc19-1459
Martens, T., Beck, R. W., Bailey, R., Ruedy, K. J., Calhoun, P., Peters, A.
L., ... & MOBILE Study Group. (2021). Effect of continuous glucose
monitoring on glycemic control in patients with type 2 diabetes treated with

basal insulin: a randomized clinical trial. JAMA , 325 (22), 2262-2272.
https://doi:10.1001/jama.2021.7444
Orem, D. E., & Calnan, M. E. (1972). NURSING. Nursing Management
(Springhouse) , 3 (1), 43-46. https://doi.org/10.1097/00006247-197201000-
00013
Root, A., Connolly, C., Majors, S., Ahmed, H., & Toma, M. (2022).
Electronic blood glucose monitoring impacts on provider and patient
behavior. Journal of the American Medical Informatics Association .
https://doi.org/10.1093/jamia/ocac069
Skinner, T. C., Joensen, L., & Parkin, T. (2020). Twentyâ€•five years of
diabetes distress research. Diabetic Medicine , 37 (3), 393-400.
Â https://doi.org/10.1111/dme.14157.
Â© 2020. Grand Canyon University. All Rights Reserved.
7
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CONHCP: Doctor Of Nursing Practice Final PICOT-D Approval
The department has conducted a review of your PICOT-D question in an effort to support the
development of your project. Please note that this review is a FINALAPPROVAL of the PICOT-
D and will require permission by the DNP Program Lead for any changes to this statement
beyond the date of this approved review. We highly discourage changes as they may prevent you
from progressing.
PICOT-D Question: In the adolescent population with mental health problems in
healthcare settings, how does PHQ-9 tool impact in-patient referrals to the mental health
department for over 9 weeks?
In the adolescent population with mental health issues: To what degree would the
implementation of the PHQ-9 depression screening tool increase the rate of referrals, as
compared to current practices, among adolescents aged 14-18 in a period of 8 weeks?
P-Adolescents aged 14-18 years.
I- Implementation of the PHQ-9 depression screening
C- Compared to current practice.

O- Increase the rate of referrals.
T- Time frame to conduct project is eight weeks.
Does the implementation of the Patient Health Questionnaire (PHQ-9) tool impact the
depression screenings and referrals when compared to current practice among adolescents
in an urban high school in Texas over eight weeks?
Are you an APRN? (mandatory question) I am an APRN having earned a graduate-level
degree All projects must have a minimum of 3 original research studies to support the
intervention. (One of the three original research articles to support your intervention need to
come from the US or Canada). The other research studies can come from the UK, Denmark,
India, New Zealand, or Australia (preferred) or from any of the 131 countries listed in the
International Compilation of Human Research Standards 2020.
*** In DNP-955A You will be required to have a total of 15 research articles to support the
intervention (3 from PICOT, plus other original research)
Original Research Articles (Use permalinks and attach a pdf copy of each of the
quantitative original research articles):
Alvarez, C. (2022). Enhancing Depression Screening for the Adolescent Population in the
Pediatric Emergency Department by Utilizing the Patient Health Questionnaire: A Quality
Improvement Project. Retrieved from:
https://digitalcommons.sacredheart.edu/cgi/viewcontent.cgi?article=1020&context=dnp_projects
Costantini, L., Pasquarella, C., Odone, A., Colucci, M. E., Costanza, A., Serafini, G., ... &
Amerio, A. (2021). Screening for depression in primary care with Patient Health Questionnaire-9
(PHQ-9): A systematic review. Journal of affective disorders , 279 , 473-483.: retrieved from:
https://air.unipr.it/bitstream/11381/2881953/1/1-s2.0-S0165032720328287-main.pdf
Nandakumar, A. L., Vande Voort, J. L., Nakonezny, P. A., Orth, S. S., Romanowicz, M.,
Sonmez, A. I., ... & Croarkin, P. E. (2019). Psychometric properties of the patient health
questionnaire-9 modified for major depressive disorder in adolescents. Journal of child and
adolescent psychopharmacology , 29 (1), 34-40. Retrieved from: Psychometric Properties of the
Patient Health Questionnaire-9 Modified for Major Depressive Disorder in Adolescents - PMC
(nih.gov)
Sekhar, D. L., Schaefer, E. W., Waxmonsky, J. G., Walker-Harding, L. R., Pattison, K. L.,
Molinari, A., Rosen, P., & Kraschnewski, J. L. (2021). Screening in high schools to identify,
evaluate, and lower depression among adolescents: A randomized clinical trial. JAMA Network
Open,Â 4 (11), e2131836. https://doi.org/10.1001/jamanetworkopen.2021.31836
IMPORTANT PLEASE STOP AND READ:

This is your Final Approved PICOT-D statement. Please maintain this copy and please
include it in each course ISP going forward, in addition, this is the FINAL approved
statement to be shared with all DNP course instructors going forward.
If you need to make a change to this PICOT-D statement, you must work with your current
course instructor to review and approve any possible changes and your instructor must
notify the DNP Program Lead. Making a change to your PICOT-D statement past this date
may lead to your delay and success in this program, there must be a valid significant
reason to change this PICOT-D statement going forward. It will require you to stop and re-
gain permission prior to progressing. This final approval is tracked in CRM.
You may not begin your intervention or collect any data related to your project until you have
GCU IRB approval, which typically occurs in 960A. Prior to your project courses, you will be
working on designing a project in preparation for the submission of your proposal in 955A.
Ensure you are accessing the resources in the DC network and in the classroom. You do not need
to resubmit your PICOT to the department.
Congratulations on your work so far! We are so glad you have chosen Grand Canyon University.
THIS FINAL PICOT-D STATEMENT IS APPROVED.
_______________________________________________________Date:
_____________________________
DNP PICOT-D REVIEWER Name/Credentials
â€œFor it is God who works in you to will and to act in order to fulfill his good
purpose.â€• (Philippians 2:13)
image1.jpeg
10 STRATEGIC POINTS DOCUMENT 2
THE 10 STRATEGIC POINTS 2
DNP-820A: Translational Research and Evidence-Based Practice
August 29, 2022.
10 Strategic Points Document for a Quality Improvement Project

The 10 Strategic
Points
Title of Project
1) Title of Project
Impact the number of depression screenings and referrals to a child
psychologist
Background
Theoretical
Foundation
Literature
Synthesis
Practice Change
Recommendation
2) Background to Chosen Evidence-Based Intervention:
List the primary points for six sections.
i) Background of the practice problem/gap at the project site
One of the primary causes of disability worldwide, depression affects a
sizable percentage of the population. Persistent feelings of sadness and
guilt, changes in sleeping patterns (insomnia or oversleeping), changes in
appetite, decreased mental and physical energy, unusual irritability,
inability to enjoy once-enjoyed activities, difficulty working, and thoughts
of death or suicide are all symptoms that can be associated with any type of
depressive disorder. These "down" symptoms alone may indicate a unipolar
depressive disorder like dysthymia or severe depression if they are present.
A person may be diagnosed with bipolar illness if they experience
alternating spells of depression and euphoria. Adolescents and young adults
increasingly have difficulties with their mental health (Poppen et al., 2016).
An individual's mental health is something only they can fully comprehend,
making it difficult for friends and loved ones to spot warning signs in time
to intervene. Juvenile and young adult suicide is a major problem in today's
world. A lack of life experiences, self-confidence, and faith in one's own
skills contribute to the suicides of many young individuals.
ii) Significance of the practice problem/gap at the project site
Mental illness has been a problem that is affected the population for a long
period and worryingly young people and adolescents are experiencing
many effects that lead to some committing suicide. The stress that today's
youth encounter nowadays is the most significant of all these issues,
especially the pressure they receive based on their academic expectations
and poor communication about their troubles to their parents. There is also
a gap in the schools in terms of students receiving counseling services
because there are limited professional counselors that attend to student
needs. Despite the fact that psychologists claim stress could be caused by
anything, many young people find the rapid pace of modern life to be a
significant source of anxiety. Many young individuals are inspired to take
their own lives by the media's glorified depiction of suicide (Poppen et al.,
2016). The reality that suicide is always fatal seems to be lost on many
young people. Young people, in other words, consider suicide an option for

self-expression or as a means of making up for past misdeeds.
iii) Theoretical Foundations (choose one nursing theory and one evidence-
based change model to be the foundation for the project):
The most likely reasons for people to take their own lives are outlined in
Emile Durkheim's theory of suicide. According to the theory, a person's
lack of social integration may be a contributing factor in their decision to
take their own life after experiencing chronic depression. It is possible that
individuals do not have adequate psychosocial assistance to help them deal
with the difficulties of life (Poppen et al., 2016). There is limited
psychological assistance in schools making it a significant cause of the
burden of psychological issues that leads to chronic depression. These
individuals have weak egos because they lack sufficient social networks in
their immediate environment. It is society's fault, according to Durkheim,
because the regulations that restrict people's actions are so lax. He is of the
opinion that individuals' actions are influenced by social problems such as
the economic crisis, pressure from academic work for high school
adolescents, and particularly when such people are unable to cope with
their depression. Additionally, the notion indicates that an individual may
choose to end their own life if they have the perception that the regulations
that are in place restrict their freedom.
Evidence-Based Change Model
A wide number of approaches can be taken to bring about change in
healthcare organizations. The data, assessment, and plan (DAP) project's
activities, which include community and adolescent education, community
presentations to improve awareness of depression, and teaching positive
coping strategies, will be efficiently implemented with the use of the PDSA
model's four steps: plan, do study, and act. During the "plan" phase of the
DAP program, a group consisting of school nurses, parents, instructors, and
students themselves will serve as the program's leaders. After the planning
stage comes to the "Do" stage, which is where the actual execution of the
program takes place. The DAP program will include a variety of
components, including public education, the promotion of healthy
emotional expression among adolescents through the medium of painting,
and the instruction of coping skills (Poppen et al., 2016). The "Study" step
is where you'll be doing any kind of analysis or assessment of the program.
A few of the factors that are taken into consideration are the return on
investment, any necessary adjustments, and the possibility of unfavorable
repercussions. The final phase of the PDSA process is referred to as the
"Act." It includes conducting an in-depth analysis of the project's goals and
results.
iv) Create an annotated bibliography using the "Preparing Annotated

Bibliographies (APA 7th)" located in the Student Success Center.
https://www.gcumedia.com/lms-resources/student-success-center-
content/documents/writing-center/preparing-annotated-bibliographies-apa7-
mla8-turabian9.pdf utilizing the five (5) original research articles that
support the evidence-based intervention. This will be the foundation of the
Literature Synthesis you will have to do in DNP-820A.
Kroning, M., & Kroning, K. (2016). Teen Depression and Suicide: A Silent
Crisis. Journal of Christian Nursing, 33(2), 78.
https://doi.org/10.1097/CNJ.0000000000000254
Kroning et al. discuss the hidden epidemic of adolescent depression. They
discovered that over 11% of all teenagers and nearly a third of all high
school students suffer from depression. About one-fifth of high school
pupils (about 17%) have seriously considered suicide. Intriguingly,
adolescent depression is rarely given the attention it deserves. The article
describes the events leading up to the death of a 17-year-old girl and
discusses the warning indicators of depression that could have been
observed. Teen depression is a major public health problem. Many adults
have witnessed kids' melancholy and incorrectly assumed it was due to
hormonal changes, defiance, or general adolescent irritability. When
comparing causes of mortality among people aged 15â€“24, suicide is by
far the most common worldwide. The article provides a detailed plan that
can save the life of a depressed person and keep them from even
considering suicide.
Best, P., Manktelow, R., & Taylor, B. (2014). Online communication,
social media, and adolescent wellbeing: A systematic narrative review.
Children and Youth Services Review , 41 , 27-36
Researchers in this study used a narrative synthesis method and a valued
appraisal instrument to read the articles and analyze the findings. The
research aimed to answer the following question: "What are the positive
and negative consequences of social media among youth?" (Best et al.,
2014). Further, this study illustrates the beneficial and bad effects of social
media use on adolescents' mental health; this outcome aids me in my
investigation of the relationship between adolescent use of the internet and
their physical and mental well-being. Evidence from Best et al. (2014)
shows that social media can have both beneficial and negative effects on
adolescents' mental health; however, the authors also suggest that further
research is needed to strengthen the connection between social media and
adolescents' psychological well-being.
O'Reilly, M., Dogra, N., Hughes, J., Reilly, P., George, R., & Whiteman, N.
(2018). Potential of social media in promoting mental health in adolescents.

Health Promotion International , 1-11.
The study details the examination of three primary topics: the role of social
media in the mental health of teenagers, the benefits and problems of social
media and mental health, and the future directions for research on these
topics. Further, this lends credence to the idea that social media can have
both beneficial and detrimental effects on young people's mental health.
Finally, the study does a fantastic job of disaggregating responses by
gender and age, resulting in a wide range of perspectives on the potential
effects of social media. The concepts of social media opinion, mental
health, and views for the future of social media in the context of health
informed the design of the focus group.
Wang, X., Cai, L., Qian, J., & Peng, J. (2014). Social support moderates
stress effects on depression. International Journal of Mental Health
Systems, 8(1), 41. https://doi.org/10.1186/1752-4458-8-41
The paper explores how social support plays a role in mitigating depression
and other stress-related outcomes. A survey of college students was
administered to assess their levels of social support, stress, and depressive
symptoms. In a regression study, it was discovered that social support
mitigates the association between depression and stress. Undergraduate
students who had high-stress levels were discovered to be having
depression. The students who reported having social support from faculty
and peers were in a different situation. Anxiety manifests itself mentally
when the needs of the spirit exceed the capabilities of the body. It's very
uncommon for this to lead to additional feelings of negativity, despair, and
anxiety, all of which can stunt a person's ability to mature and flourish as a
person. Individual and environmental variables both play a role in the
development of depression.
Albert, P. R. (2015). Why is depression more prevalent in women? Journal
of Psychiatry & Neuroscience: JPN, 40(4), 219â€“221.
https://doi.org/10.1503/jpn.150205
The article discusses how common depression is among women. Major
depressive disorder is a serious health problem that affects many people. It
is estimated that in 2010, depression disorders were the second-leading
cause of burdens for Canadians with disabilities, after mobility
impairments. When people are depressed, it often results in their own death
by means of suicide or a stroke. Depression ranks as the third leading cause
of death around the world because of all these deaths. Education and
income, maltreatment, and other socioeconomic issues all have a role in
exacerbating women's already high suicide incidence.

v) Summary of the findings written in this section.
The adolescents that suffer from depression are contributed by multiple
factors that include social issues, academics, lack of support, and the
influence of social media. The limited resources for addressing mental
health in high school result in cases of chronic depression. There is a need
for screening to assist adolescent students in the preliminary stages and
avoid cases of depression.
Problem Statement
3) Problem Statement:
Depression is a huge problem among adolescents in high school and prior
screening through schools having enough counsellors and creating
awareness help in mitigating the risks and consequences.
PICOT to
Evidence-Based
Question
4) PICOT Question Converts to Evidence-Based Question:
The purpose of this quantitative, quasi-experimental quality improvement
project is to determine if or to what degree the translation of research by
Anand et al. utilizing the Patient Health Questionnaire-9 (PHQ-9) will
impact the number of depression screenings and referrals to a child
psychologist when compared to current practice among adolescents at a
high school setting in urban Texas over eight weeks.
Sample
Setting
Location
Inclusion and
Exclusion Criteria
5) Sample, Setting, Location
The sample size targeted is 15 participants and the study setting is the urban
area of Texas. High school adolescents and counselors are the target
participants.
Define Variables
6) Define Variables:
i) Independent Variable (Intervention): Therapy/counseling and having
enough counsellors.
ii) Dependent Variable (Measurable patient outcome): Depression
Project Design
7) Project Design:
However, research findings do not have to be immediately integrated into
clinical practice, the fundamental purpose of quality improvement programs
is to improve patient care. To identify a problem, research must be
undertaken, and quality enhancement entails gathering evidence that can be
used to better the topic of interest.
Purpose Statement
8) Purpose Statement:
The purpose of this quality improvement project is to determine if the

implementation of therapy/counseling intervention would impact the mental
health well-being among high school adolescents. The project was piloted
over eight weeks in an urban setting within Texas state.
Data Collection
Approach
9) Data Collection Approach:
To gather and analyze demographic data, I plan to use an Excel
spreadsheet. By consulting with healthcare professionals and conducting
the survey with 15 participants, I will be able to collect valid and
trustworthy data on patient outcomes. To ensure that the collected data can
be replicated, the survey instrument employs a standardized, organized
format. In the realm of data collecting and analysis, spreadsheets are widely
regarded as among the most efficient and trustworthy tools available.
i) Describe the step-by-step process you will use to collect the data, explain
where the data will come from, and how you will protect the data and
participants.
I would first seek the approvals from necessary authorities and also get the
consent from the target participants that is the counsellors and high school
adolescents. The participants are 15 in number from Urban Texas.
High school adolescent patients in mental health care are given an
evaluation questionnaire to fill out, with two weeks allotted to finish the
process. The questionnaire itself takes only a few minutes to complete. To
acquire this data, we have them fill out a questionnaire and record their
responses in a spreadsheet. A copy of the encrypted data is subsequently
uploaded to a remote server.
ii) Discuss potential ethical issues pertaining to your project. Ethical
Considerations in Human Research Protection (i.e., confidentiality vs
anonymity of the data, informed consent, and potential conflict of interest.)
Participants are needed to sign the informed consent form as soon as they
agree to take part in the study, demonstrating their willingness to allow the
data to be shared. The participants' anonymity is protected by the
confidentiality guarantees inherent in the informed consent process. The
participant has the moral right to expect that their date would be kept
private and discreet. There should be no potential conflict of interest
between the researcher and the participant.
iii) Discuss how you will adhere to the principles of the Belmont Report
(respect, justice, and beneficence) in the project design, sampling
procedures, within the theoretical framework, clinical problem, and clinical
questions.
I would analyze the Belmont report and make sure that all the requirements

are adhered to in the research study.
Data Analysis
Approach
10) Data Analysis Approach:
Using a descriptive statistical method and demographic analysis, I would
examine the provided descriptive data and demographic information. If I
were to analyze the quantifiable patient outcomes, I would use the chi-
square test. In this case, I would resort to the techniques employed by
statisticians. A possible source of error in the data is that respondents
provided false information, especially about demography. To deal with this
difficulty, we can establish a range within which each given piece of data
should lie to ensure that our results can be reproduced.
References
Albert, P. R. (2015). Why is depression more prevalent in women? Journal
of Psychiatry & Neuroscience: JPN, 40(4), 219â€“221.
https://doi.org/10.1503/jpn.150205
Best, P., Manktelow, R., & Taylor, B. (2014). Online communication,
social media, and adolescent wellbeing: A systematic narrative review.
Children and Youth Services Review , 41 , 27-36
Kroning, M., & Kroning, K. (2016). Teen Depression and Suicide: A Silent
Crisis. Journal of Christian Nursing, 33(2), 78.
https://doi.org/10.1097/CNJ.0000000000000254
O'Reilly, M., Dogra, N., Hughes, J., Reilly, P., George, R., & Whiteman, N.
(2018). Potential of social media in promoting mental health in adolescents.
Health Promotion International , 1-11.
Poppen, M., Sinclair, J., Hirano, K., Lindstrom, L., & Unruh, D. (2016).
Perceptions of Mental Health Concerns for Secondary Students with
Disabilities during Transition to Adulthood. Education And Treatment Of
Children , 39 (2), 221-246. https://doi.org/10.1353/etc.2016.0008
Wang, X., Cai, L., Qian, J., & Peng, J. (2014). Social support moderates
stress effects on depression. International Journal of Mental Health
Systems, 8(1), 41. https://doi.org/10.1186/1752-4458-8-41
College of Doctoral Studies
Ten Strategic Points: QUANTITATIVE
Aligns with new v9.0 Template
Please find below an updated copy of the 10 strategic points that is focused on a quantitative
study. This copy includes tips in the right-hand column to guide you as you develop your 10

strategic points. Delete the bulleted items in the right column as you add your own information
there.
QUANTITATIVE STUDY
The ten strategic points
emerge from researching
literature on a topic, which is
based on, or aligned with a
defined need or problem
space within the literature as
well as the learnerâ€™s
personal passion, future
career purpose, and degree
area. The Ten Strategic Points
document includes the
following key points that
define the research focus and
approach:
Strategic Points Descriptor
Learner Strategic Points for
Proposed Study
1.
Dissertation Topic - Provides a
broad research topic area/title.
Topic comes out of problem
space supported by the
literature, not the learnerâ€™s
head or personal agenda
Aligned to the learnersâ€™
program of study, and ideally
the emphasis area
Researchable and feasible to
complete within the
learnersâ€™ doctoral program
of study including extension
courses as needed.
Focused
2.
Literature Review - Lists
primary points for four sections
in the Literature Review: (a)
Background of the problem and
the need for the study based on
citations from the literature; (b)
Theoretical foundations (theories
Â· Background to the problem
Â· Literature is predominantly
from past 5 years
Â· Historical treatment of

,models, and concepts) and if
appropriate the conceptual
framework to provide the
foundation for study); (c)
Review of literature topics with
key themes for each one; (d)
Summary.
problem being studied
Â· Clearly defines a stated need
Â· Theoretical foundation
Â· Theories, models, or
concepts and if appropriate the
conceptual framework are
described to guide the research
and the data collection
Â· Review of literature topics
Â· Relevant to the topic
Â· Demonstrates breadth of
knowledge
3.
Problem Statement - Describes
the problem to address through
the study based on defined needs
or problem space supported by
the literature
Â· Statement is structured
appropriate for the design
Â· Researchable
Â· Quantitative: Researchable
variables to be better
understood
4.
Sample and Location â€“
Identifies sample, needed sample
size, and location.
Â· Size is appropriate for
design
Â· Likely to be able to access
it/get permission
Â· Identify alternative to their
organization (associations,
community orgs, research
companies, snowball sampling,
etc.)
5.
Research Questions â€“
Provides research questions to
collect data to address the
problem statement.
Â· Appropriate for the design
Â· Resulting data will address
the problem statement
Â· Minimum of 2
6.
Hypothesis/Variables - Data
sources are valid; variables are
Â· Quantitative: Data sources
are valid; variables are clearly

clearly defined and measurable
(quantitative)
defined and measurable
Â·
7.
Methodology and Design -
Describes the selected
methodology and specific
research design to address the
problem statement and research
questions.
Â· Methodology and design
sections
Â· Appropriate for problem
statement
Â· Justifies the methodology or
design using problem statement
and citations
Â· Methodology does not
discuss design, instrument, data
collection
Design does not discuss
instrument, data collection, data
analysis
8.
Purpose Statement â€“
Provides one sentence statement
of purpose including the problem
statement, methodology, design,
target population, and location.
Â· Purpose statement =
Methodology + design +
problem statement + sample +
location
Â·
9.
Data Collection â€“ Describes
primary instruments and sources
of data to answer research
questions.
Â· Quantitative:
Validated/previously used
instrument or data source
clearly identified for each
variable; demographic variables
identified and appropriate to the
study. Comment by GCU: In
quantitative studies various
demographics can be variables.
One might compare
transformational leadership
behaviors for males and
females or different
management levels within an
organization or between
different age groups. Or
demographic variables might be
one of the predictor variables in

a hierarchical regression
Â· Describes sample; various
permissions needed; recruiting
and select final sample; data
collection steps; how data will
be stored, security maintained,
privacy maintained
10.
Data Analysis â€“ Describes the
specific data analysis approaches
to be used to address research
questions.
Â· Quantitative: Include testing
assumptions; descriptive
statistics; specific inferential
statistics appropriate for design
and type of variables;
appropriate for hypotheses
Â· Data analysis approach
aligned to the
design/variables/RQs &
hypotheses
2 Quantitative 10 Strategic Points, v. 9.0 August 10, 2020

Grand Canyon UniversityDNP-830A- Data AnalysisOctober 6- 202210 Strate.docx

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